The University of Toronto (UT) and its affiliated hospitals have
become embroiled in another controversy regarding their attitude
to corporate donors versus their behavior towards employees.

David Healy

British
psychiatrist David Healy accepted a senior position at the Centre
for Addiction and Mental Health (CAMH) and the Department of Psychiatry
at UT only to have the offer withdrawn months later on the basis
of a speech he made at the University. The speech was highly critical
of the pharmaceutical industry.

Healy,
the Director of the North Wales Department of Psychological Medicine
at the University of Wales in the UK, is a prolific author and
his views on neurological medicines are widely known. He has acted
as a medical expert in several legal cases involving antidepressant
drugs.

He
says he was courted by CAMH faculty over a period of 18 months
to join the group as Clinical Director of the Mood and Anxiety
Disorders Program and as a Full Professor in the Department of
Psychiatry at UT. He formally accepted the offer on 13 September,
2000 and proceeded to apply for an immigration visa for himself
and his family.

On
30 November last year, Healy took part in a symposium at UT and
presented a lecture that he subsequently repeated at Cornell University,
New York, and at the Centre for National Research in Health in
Paris. The talk also forms the synopsis of a forthcoming Harvard
University Press book.

Despite
an evaluation form showing that Healy's talk was rated highest
for 'content that met the audience's needs and objectives'above
that of speakers such as Steven Hyman, director of the US National
Institute of Mental HealthHealy's future bosses took offense
to the speech. On 8 December, David Goldbloom, Physician-in-Chief
at CAMH emailed Healy canceling his faculty appointment. Goldbloom
wrote, "...we believe that it is not a good fit between you
and the role as leader of an academic program...This view was
solidified by your recent appearance at the Centre in the context
of an academic lecture...."

The
lecture was an historical account of psychiatric medicine
and was highly focused on the role of the pharmaceutical industry.
For example, Healy said the reason for the development of
new antipsychotic drugs was to create medicines without the
tardive dyskinesia side-effects of older drugs and not because
these were better for the disease symptoms of schizophrenia.
Regarding institutionalization, he said patients in Britain
"are being detained at 3 times greater rate than 50 years
ago."

He
repeated his views on antidepressant drugs: "I happen to
believe that Prozac and other SSRIs can lead to suicide. These
drugs may have been responsible for 1 death for every day that
Prozac has been on the market in North America." And he went
on to question why no research has been carried out to determine
whether the drug does or does not cause suicide.

Towards
the end of the lecture, Healy said that the information from the
human genome will give rise to products belonging "almost
exclusively to pharmaceutical corporations. If they are advised
in the way that they are at present, this knowledge, which is
so democratically important, will operate against the interests
of democracy."

The
manufacturer of Prozac, Eli Lilly, is acknowledged on CAMH's website
to be its largest sponsor, having donated over CAN$1 million (US$645,000).
While no-one is suggesting that Lilly played any part in the decision
to sack Healy, some are questioning whether CAMH faculty were
sufficiently worried about offending donors that they sacrificed
the recruitment.

Jim Turk

CAMH
denies that the issue rests on Healy's statements about Prozac.
Paul Garfinkel, chair of Psychiatry at UT, told Nature Medicine,
"Our search committee knew of his views on Prozac, but that
alone doesn't do it. It was the variety of extreme views [in his
talk] based on extraordinary extrapolations and incompatibility
with scientific evidence. ...his views...shocked a large number
of future colleagues to the point where they felt he did not have
the respect and support of the staff."

Specifically,
Garfinkel cites Healy's comments about the rise in psychiatric
hospitalization and his claim that "a significant proportion
of the scientific literature is now ghost written [by people in
the pharmaceutical industry]." Garfinkel says, "We have
no idea where this comes from. Dr Healy has made sweeping statements
that do not meet the standards of science."

The
case has caught the attention of the Canadian Association of University
Teachers (CAUT), an organization that represents 30,000 faculty
across Canada. CAUT does not buy CAMH's explanation for canceling
Healy's appointmentor see why such a lengthy and detailed
hiring process can be reversed on one lectureand is calling
for an independent inquiry into the issue. "We are quite
appalled at what appears to be a flagrant violation of academic
freedom. Here's an institutionboth CAMH and UTthat
is uncomfortable having an outspoken critic of the pharmaceutical
industry," says CAUT Executive Director, Jim Turk. "We
will launch our own investigation if necessary, as we have had
to do in the Olivieri case. That report is due out next month."
(see overleaf).

Turk
told Nature Medicine, "We think there's a very dark cloud
over the University of Toronto and its affiliated teaching hospitals.
We're sending out a message that this top notch university isn't
prepared to tolerate dissent and diversity of viewpoints and amongst
medical researchers."

The
Faculty Association at UT has also filed a notice of Breech of
Academic Freedom and will proceed to a formal grievance procedure
if the University does not respond in 3 weeks. Meanwhile, Healy
is considering whether to file a legal suit against CAMH for breech
of contract.